Rhabdo and CrossFit
Why Should I Care About Rhabdo?
Because it can kill you. Rhabdomyolysis (rhabdo) is a rare but serious health condition sometimes caused by working out at very high intensity. CrossFit workouts, just like all high intensity workouts, have the potential to cause rhabdo under the right circumstances. Rhabdo is very, very rare. But even though it’s very rare, it’s also very serious. So reading this article is an important step towards keeping you safe while still experiencing all the great things CrossFit has to offer.
If you feel terrible after a workout, then the next day extreme swelling and soreness starts, and then you start peeing brown urine—you have rhabdo. Go to the ER immediately. This is no joke. It can be fatal if not treated. Rhabdo happens when your muscles break down to the point that muscle tissue enters your bloodstream. Your kidneys can’t handle this. They freak out and eventually shut down. This is how rhabdo can be fatal—kidney failure. The most important thing you can learn from this entire article is this: If you experience dark urine after a grueling workout, then go to the ER immediately.
What are the Symptoms of Rhabdo?
1. extreme muscle pain and soreness swelling
2. difficulty moving the affected muscles
3. weakness in the affected muscles
4. dark urine (brown, cola-colored)
What type of workouts cause rhabdo?
Using light loads for many, many repetitions in a long workout is the usual culprit. Performing many reps of one movement in a row without changing movements or resting can also be a factor. However, heavy lifting generally does not cause rhabdo. Lifting heavy loads forces you to stop before severe muscle breakdown occurs. For example: performing 5 sets of 5 squats at a heavy load is not a workout that carries a rhabdo risk. However, performing 1 set of 100 squats as quickly as possible with a light load would carry a rhabdo risk.
Who generally gets rhabdo?
Not many people at all. Rhabdo is very rare. It’s highly unlikely, but if it does happen, the consequences are severe. Classic literature often tells us that men have higher risk of rhabdo than women. While this is historically true, I think this may be rooted in past social norms, and not biology. As CrossFit continues to build strong, determined women, they too need to be cognizant of rhabdo. Next, rhabdo usually strikes someone who has been away from intense exercise for a while and then jumps back in with too much volume and intensity. Someone who has been very fit in the past and has taken six months off must ramp up volume slowly as he returns to intense exercise. This type of athlete has the mind and the determination to push himself beyond his body’s capabilities—where rhabdo lives.
What movements cause rhabdo?
Well, there’s no magic movement that always causes rhabdo. But some movements are higher risk than others when performed by new athletes or when performed to excess repetition. These are usually movements with a demanding eccentric motion. Stay with me. This really isn’t too complicated. Most movements have two parts: an eccentric part and a concentric part. Eccentric means that muscles are stretched under load. As you lower into the bottom of a squat, you are performing the eccentric portion of the squat. Your hamstrings are lengthening under load. Concentric means that muscles contract under load. As you drive out of the bottom of the squat you are performing the concentric portion. After being stretched, your hamstrings are now contracting and driving the load upwards. Eccentric motion is very demanding on muscles. Stretching muscles under a load with lots of repetition can cause the muscle breakdown that triggers rhabdo. Here are a few examples of movements with a strong eccentric portion: jumping pullups, GHD situps, walking lunges. Now these are all excellent movements that have their uses in building a strong and healthy body. Just don’t jump into doing hundreds of them, unless you’re a strong and experienced athlete that has worked up to that level of ability.
What should I do to prevent rhabdo?
Gradually build up volume and intensity in your workouts, especially after a long break from exercise. Your first workout after a break in training should get your heart rate up and allow you to do some work, but it shouldn’t be crushing. You should leave the gym feeling better than when you arrived. Note that there is a time and a place for workouts that push your limits. Your first day back after a cruise to the Bahamas is not that time and place.
Even if you have been exercising regularly, jumping to a much higher intensity too suddenly can be dangerous. This doesn’t mean that you should not work out at high intensity. This means that you should ramp up your intensity slowly, over several weeks or even months.
Don’t fear putting weight on the bar. Lifting heavy weight forces you to stop and prevents rhabdo. Rhabdo comes from performing way too many reps at a light to medium load.
Listen to your coach. Your coach is your co-pilot for training. When you press the gas pedal to the floor with reckless abandon, your coach is there to prevent a catastrophic crash. He can’t ultimately control the vehicle. You’re the pilot. But he will exert as much influence as you will allow, so trust him and allow him to guide you.
Give your coach information. Your coach doesn’t live in your shirt pocket. He doesn’t know that you drank a thimble of water over the past two days and ran a half-marathon for fun after yesterday’s deadlifts. Be honest with your coach about how you feel that day.
Hydrate before, during, and after your workout. Does that mean you should visit the water fountain during short metcons? Sometimes. If you hydrate adequately before your workout, then you probably don’t have to visit the water fountain during a 10-minute effort. If you didn’t hydrate well prior to beginning your workout, then you should indeed visit the water fountain as much as needed. But this isn’t always necessary if you drink water throughout the day. For a 20-minute workout or more, get some water during strategic rest breaks. And after the workout is over, drink copious amounts of water–always.
Even if you and your coach does everything right, sometimes the perfect storm of circumstances can conspire against you. That’s why it’s important that you know the warning signs, symptoms, and what to do if you think you have rhabdo.
If you have any questions or concern, please contact Jason for more information. Knowledge is key.

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